Difficult BFing experience - need help!

Hello! I'm new to LLL. After consulting with several LCs I hope that real moms can give me advice. My lovely baby boy is almost 3 weeks old. We had a difficult vaginal delivery. He had a lot of heart decelerations and ended up coming out with his arm next to his head and the cord wrapped around. He was taken right away to NICU for breathing difficulties. It was also hard on me-pushing for 3 hours and a 2nd degree tear. Our BF experience didn't start the way I'd dreamt. We didn't have skin to skin until the next day but I get to try nursing him. He was never given a bottle or pacifier. He was a little jaundiced and wasn't peeing so he was very sleep until my milk came in. Then he got better.

But I've become worse. From the beginning I've had a lot of nipple soreness. I was told that it would go away. My nipples had little red blisters that have gone away. My mom started making a big deal about his frequent watery poops (which everyone said was normal) so I overanalyzed and thought he was getting too much foremilk. I started getting him to stay on one breast until the next feed when I would switch to the other. But going 4-6 hours for each breast I became painfully engorged. None of my nursing bras fit and were too tight. So I've developed a bunch of plugged ducts and mastitis. The outside of my right breast is hard red swollen. I had a fever. I'm on antibiotics and alternating hot n cold with massage to clear out the duct. But that side feels so hard and lumpy I can't imagine much is coming out of it. My nipples are still sore. Water or tshirts rubbing against them sting. It usually hurts with initial latch then eases up but sometimes it starts to sting again while he nurses. Like a strong pinching. Stinging. Sometimes he slips down the nipple and has more of the tip. Sometimes it feels like he's gumming my nipple like he's closing down on it. I don't think the arreola is as deep I'm his mouth as it should be but at only 6.5 lbs his mouth is pretty small. My nipple is bigger than his nose! It's also hard to get his bottom lip to stay curled out. It rolls back in. His bottom jaw also seems to close in.

I've tried all the tricks. Nipple sandwich. Tickling lips. Asymmetrical latch. It seems like luck if I get it right. But what's getting me the most is frustration with him on other nursing problems.

1. He will only nurse in cross cradle. He cries and fights other positions and I can't bring him to the breast.
2. Even in cross cradle he turns his head every way except towards the nipple. All the way backwards. It takes about 5 minutes to get him latched. If I let him lead on his own he tries to get it but then keeps letting go. Like he needs me to pop it in his mouth.
3. His hands are everywhere! They scrape my nipples. I can't see his mouth to latch. Or he sucks on his own hands.
4. Comfort sucking. I don't mind it at all but it makes my nipples so sore. He also starts about 9pm til about 12:30am. I would be able to lean back and relax if not for the soreness after a while. When he's half asleep he loosens up on the nipple and flicks me more with his tongue.
5. Tongue flicking - he will flick the tip of my nipple with his tongue in his moth then start sucking. This makes me think his tongue isn't down over his gum. I don't know how to fix this.

As a last resort I would pump n bottle feed and I suppose I can mix in a bottle after a week but I don't want to lose the nurturing and closeness of feeding from the breast. But with the above issues and the soreness I still have I need help. The LCs never seem to offer advice other than keep trying do it this way and the pain is supposed to go away. Get through the first two weeks. The engorgement has eased up but the breasts still have heavy sore spots and my nipples are so tender.

Please give me some tips on these issues before I give up. It's been so frustrating at times typically late at night.

Re: Difficult BFing experience - need help!

Welcome to the forum and congratulations on the new baby!

The creased, flattened nipple you describe- that's a very good indicator of a shallow latch. For a lot of people, the "new lipstick" description fits, in terms of shape- there's a ridge across the top, a rounded side, and a flattened side... Did anyone check your baby for a tongue or lip tie? Sometimes that can cause persistent latch issues, and they could match with the "tongue flicking" you're experiencing. But often shallow latch issues are just caused by the baby being small, with a mouth that can't achieve a particularly deep latch even when mom is doing all the tricks- nipple sandwich, asymmetrical latch, etc. This is when you get stuck with the "be tough, be patient" advice; if you are tough enough for long enough your baby will grow out of the problem and you'll be nursing pain-free. The fact that you're not mentioning any cracks or blisters suggests that you'll see improvement sooner rather than later, maybe within the first month or so. (Of course there are no promises- I hate it when people tell moms " Oh, everything gets better by 6 weeks" because for some moms, that's just not true!)

Have you tried nursing in a reclined position? Sometimes that helps, and it's worth a try even if your baby is very picky about positioning. Be patient with him over positions- he will eventually discover other ways of nursing. But with a newborn, often you simply do what works.

Don't worry about your baby needing help to latch. Again, this is probably a problem that is caused by him being very young. Newborn babies are instinctively driven to latch but not that skilled at it. They often thrash, unlatch, bob their heads, etc. you just have to be patient and let the baby learn the skill of latching on. It may help to get to him before he becomes frantic, offering to nurse at his earliest cues or even before he starts giving you cues. If he does get frantic, try offering him your pinky finger to suck (nail held down towards the resilient tongue rather than directed up towards the delicate palate). A few seconds of sucking on a pinky may calm him enough for a repeat latch attempt. Expressing some milk onto the skin of the nipple before latching the baby on may also help, since the milk will provide an instant reward for latching and may promote suckling.

For a baby who thrashes and scratches, you can swaddle him and/or put his hands in mittens or just little socks.

Comfort nursing is really important for a baby this age, so you don't want to limit it. But if your baby is comforting himself for hours on end, sucking erratically and lightly, you can take him off the breast, burp him and change his diaper, and latch him on again if he fusses. Let him nurse, just try to get him latched on as well as possible during the long evening cluster feed.

Hang in there, mama! I know from experience that what you are doing is very difficult, and it seems like there can't possibly be a light at the end of the tunnel. But there is!!!

Re: Difficult BFing experience - need help!

Have you seen a board-certified lactation consultant (IBCLC)for a private one-on-one consultation that lasts at least 90 minutes? It does sound as if you have some severe latch issues and that is what I lactation consultant is supposed to help you with I'm frustrated that you're not getting better help.
Aside from the latch issues, Assuming baby is gaining normally, you may be having issues with overproduction. At this point the best thing to be doing is to be getting milk out of the breasts as frequently as possible. It does not have to all come out there is no need to worry about 'emptying' the breast as some claim. What is most important is that you get the milk out of the breasts frequently. Engorgement not only causes all kinds of health issues for mother, it also can make latching even more difficult for baby.
I can tell you in my personal experience with difficult, painful latch, small baby, and engorged breasts that it does get better but the way it gets better is with the milk being removed very frequently, With the latch improving, And with care taken to make sure that the nipples heal.
For frequent milk removal, With my babies I would try to encourage them to nurse as much as possible. When they were not going to nurse as frequently as I needed, I used hand expression to relieve the pressure on my breasts. Pumps can also be used but pumps cause additional issues sometimes basically you have to figure out what's going to work best for you.

Re: Difficult BFing experience - need help!

Oh and I second suggestion for trying laid-back positioning. You don't have to be very much laid-back and baby can still be in the cross cradle if that's what baby prefers. Baby could be in any position and mother can be in any rate of recline it just means not sitting straight up or hunched over. When moms are having lots of trouble with latching sometimes they find it is easier for them to latch baby in a more sitting up or hunched over position, and then lean back. Doing it that way Will not help with initial latch, but it will make nursing more comfortable overall and baby less likely to be thrashing during the nursing session. The idea behind laid-back is both mother and baby are in a more relaxed and supported position so both mother and baby are more relaxed and gravity is working for you rather than against you.

Re: Difficult BFing experience - need help!

Thank you for the advice. I don't know if I mentioned this in the first post but what I think he's doing is gumming my arreola with his lower jaw and then rubs my nipple with his tongue. I think his tongue is supposed to be over his gums right? I feel an abrasion on my nipple and I think that does feel like taste buds on the tongue. I agree that his latch is shallow. I don't have big breasts though nursing bra sizes suggest otherwise. I'm normally just a 34a. But they're very full round and perky. Like they come straight out to a point. < > so I think they're too full at the nipple for them to go in deeply. I'll keep trying. I just wanted to hear that it is something that should get better if we keep trying and that it isn't anything I'm doing wrong.

I'm in a big city but the certified LCs work at the hospital or there are two at his pediatrician. They came by at the hospital but I don't know what they do now that I'm out. At the pediatrician I've only been able to meet for about 30 mins. How do I arrange for longer sessions? Where do I go? I want someone to latch him on for me and show me tricks or training for him on how to open or use his tongue better. I don't know who to turn to.

I was in tears last night again because I couldn't get him to sleep without comfort sucking and my nipples were just burning. I hate feeling like I don't want to nurse him and want him to go to sleep so I get a break from the pain. I feel so much better when he's not been on. It's starting to hurt my bond with him because I'm so frustrated. Thank you again.

Getting your pediatrician to give you a long visit is generally difficult. Docs and other medical professionals tend to be really good at slipping out of the office when the 20-30 minutes they have allotted for you is up. The best way to get one to stay is to say " WAIT. I have more questions." If they say they need to get to their next appointment, make it clear that you need more help.

Please don't worry about your bond with your baby. A lot of moms have this idea that breastfeeding and bonding is going to be this loving, rosy, comfortable experience. Just mom and baby gazing at each other as baby peacefully suckles to satiation and sleep... And sometimes it does happen that way! But often it's more like mom and baby are going through a war together. It's tough, scary, painful, there's a lot of screaming and crying. And yet mom and baby still emerge with an unshakeable bond. Give yourself time, you're in the investment stage of breastfeeding. They pay-off comes later.

Re: Difficult BFing experience - need help!

Oh mama, I hear you on the discomfort (aka pain) in feeding a newborn. I'll say it didn't get truly comfortable for us until the 8th or 9th week. It sounds like your baby's tiny mouth has trouble with a really full breast. Can you hand express just a little to soften up the nipple? Also, ibuprofen is a-ok and takes the edge off. You might want to check out "soothies" breast pads by lansinoh. They're for wound healing but even without an actual wound, the feel marvelous. These things might get you through while you wait to get in w an IBCLC, hopefully that's just a day or so!
Also, a pacifier, while often warned against, can be a lifesaver when used judiciously.